title: [Acute myelogenous leukemia developed at the 26th week of gestation].
abstract: We report here a 35-year-old pregnant woman with acute myelogenous leukemia (AML). She was diagnosed with AML (M2) in August 2009, coinciding with the 26(th) week of pregnancy. She underwent a cesarean section at 27 weeks gestation, delivering a very low birth weight male infant (1,066 g). One week later, she received induction chemotherapy with idarubicin and cytarabine. She achieved complete remission after two courses of chemotherapy. The incidence of acute leukemia during pregnancy is low. Chemotherapy after the 2(nd) trimester is not associated with an increased rate of fetal malformation. However, there are some reports that in utero exposure to chemotherapy during any trimester of pregnancy carries a significant risk for an unfavorable outcome including low birth weight, fetal or neonatal death, and intrauterine growth retardation. Decision on the choice of treatment for acute leukemia during pregnancy should be case-dependent. If an infant has grown sufficiently to be viable outside uterus and the patient does not demonstrate a severe bleeding tendency, delivery by cesarean section preceding chemotherapy is one option.
authors.affiliation: Department of Hematology/Oncology, Teikyo University School of Medicine.
authors.forename: Haruko
authors.initials: H
authors.lastname: Tashiro
authors.forename: Koichi
authors.initials: K
authors.lastname: Umezawa
authors.forename: Michihiko
authors.initials: M
authors.lastname: Shirota
authors.forename: Yoko
authors.initials: Y
authors.lastname: Oka
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Shirasaki
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Nishi
authors.forename: Akinori
authors.initials: A
authors.lastname: Taguchi
authors.forename: Nobu
authors.initials: N
authors.lastname: Akiyama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kawasugi
authors.forename: Takuya
authors.initials: T
authors.lastname: Ayabe
authors.forename: Naoki
authors.initials: N
authors.lastname: Shirafuji
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002585:Cesarean Section; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012074:Remission Induction
chemical_list: D003561:Cytarabine; D015255:Idarubicin